Thesis (M.S.)--University of Michigan, 1988.

Thesis (M.S.)--University of Michigan, 1988.

Thesis (M.H.A.)--University of Michigan, 1958.

Thesis (M.S.)--University of Michigan, 1982.

Thesis (M.H.A.)--University of Michigan, 1958.

Thesis (M.S.)--University of Michigan, 1982.

The number of older persons is growing at a shocking rate. In spite of this reality, the South African health care sector does not prioritise older persons, causing their health to be poorly managed. Not only does poor health management affect the health of the older person, but also economic factors. This causes a high burden on the public health sector of South Africa, with specific reference to the Primary Health Care (PHC) clinics. PHC clinics in this country are not only overcrowded due to staff shortages, but also owing to the rapidly ageing population and the large number of younger persons affected by the high unemployment rate of South Africa. The above-mentioned factors keep the professional nurses in the clinic from spending time on proper physical examinations and provision of health education to older persons. This causes older persons to lack knowledge regarding self-care, potentially leading to unintentional self-neglect, which decreases their quality of life. Studies conducted on older persons concluded that the older person wants to be involved in health promotion, but needs the necessary knowledge to take care of him- or herself. Therefore, the researcher's overarching aim with this study was to develop guidelines to facilitate self-care amongst older persons. Such guidelines aim at constituting an indirect approach to promote the health of the older person. Health education on self-care should be conducted in self-care support groups, since community experience teaches that some older persons in the community do not apply self-care skills learned without some form of support. The aim with these guidelines is to decrease unintentional self-neglect by empowering the older person to make autonomous decisions regarding self-care, in order to increase quality of life. RESEARCH AIM AND OBJECTIVES In order to reach the overarching aim of this study, which comprises the development of guidelines to facilitate self-care amongst the older persons in the Potchefstroom district, the study firstly includes a literature review to understand self-care and related constructs from a theoretical perspective. Secondly, the Appraisal of self-care agency scale-A (ASA-A) and Exercise of self-care agency scale (ESCA) were used as questionnaires to assess the self-care of the selected older persons. Lastly, after determining the self-care of the older persons, the study investigates the relationship between these two questionnaires through correlational analysis. RESEARCH DESIGN A quantitative, descriptive, correlational and contextual design was used in this study to .reach the overarching aim and respective objectives. RESEARCH METHOD The researcher firstly conducted a literature review to understand self-care and related constructs. Thereafter the researcher employed two structured questionnaires, the ASA-A and ESCA, were employed to collect data. The questionnaires were developed to measure self-care (self-care is determined by measuring the self-care agency). These questionnaires were based on Dorothea OrenYs self-care deficit theory of nursing, the same theory that this research study is based on. Minor adaptations were made to both the questionnaires prior to administration to the predominantly Setswana-speaking older population. The study formed part of the larger Multinational Prospective Urban and Rural Epidemiological study (PURE-SA study - ethical approval number 04M10). All the older persons identified in the peri-urban population of the PURE-SA study living in the Potchefstroom district and who were willing to participate were included in the sample. Trained fieldworkers assisted the researcher in data collection. Of the 198 older persons, 192 participated, accumulating to a 98% response rate. Lastly the researcher correlated the ASA-A and ESCA to determine their relationship as an added benefit to this research study. RESULTS The findings indicate that although the studied older population was of a lower socio-economic status with a lower literacy level, their overall self-care was relatively good. Seven self-care deficits were identified namely time management skills affecting self-care, energy deficit affecting self-care, sleep deprivation, lack of knowledge and ability to acquire knowledge with regard to health and self-care, lack of a rest, exercise and self-care programme, self-care deficit caused by physical deterioration and, lastly, the lack of performance of activities to prevent/decrease self-care deficits. These identified self-care deficits supported the development of guidelines to facilitate self-care amongst older persons, together with Menon's psychological health empowerment model, as well as an in-depth literature review on self-care and related constructs to understand self-care from a theoretical perspective. Furthermore, the study compared the ASA-A and ESCA questionnaires to determine the relationship between these questionnaires. The two questionnaires had a very good correlation with each other, conclusion that either of these two questionnaires could be used to measure self-care of a population. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2010.

The number of older persons is growing at a shocking rate. In spite of this reality, the South African health care sector does not prioritise older persons, causing their health to be poorly managed. Not only does poor health management affect the health of the older person, but also economic factors. This causes a high burden on the public health sector of South Africa, with specific reference to the Primary Health Care (PHC) clinics. PHC clinics in this country are not only overcrowded due to staff shortages, but also owing to the rapidly ageing population and the large number of younger persons affected by the high unemployment rate of South Africa. The above-mentioned factors keep the professional nurses in the clinic from spending time on proper physical examinations and provision of health education to older persons. This causes older persons to lack knowledge regarding self-care, potentially leading to unintentional self-neglect, which decreases their quality of life. Studies conducted on older persons concluded that the older person wants to be involved in health promotion, but needs the necessary knowledge to take care of him- or herself. Therefore, the researcher's overarching aim with this study was to develop guidelines to facilitate self-care amongst older persons. Such guidelines aim at constituting an indirect approach to promote the health of the older person. Health education on self-care should be conducted in self-care support groups, since community experience teaches that some older persons in the community do not apply self-care skills learned without some form of support. The aim with these guidelines is to decrease unintentional self-neglect by empowering the older person to make autonomous decisions regarding self-care, in order to increase quality of life. RESEARCH AIM AND OBJECTIVES In order to reach the overarching aim of this study, which comprises the development of guidelines to facilitate self-care amongst the older persons in the Potchefstroom district, the study firstly includes a literature review to understand self-care and related constructs from a theoretical perspective. Secondly, the Appraisal of self-care agency scale-A (ASA-A) and Exercise of self-care agency scale (ESCA) were used as questionnaires to assess the self-care of the selected older persons. Lastly, after determining the self-care of the older persons, the study investigates the relationship between these two questionnaires through correlational analysis. RESEARCH DESIGN A quantitative, descriptive, correlational and contextual design was used in this study to .reach the overarching aim and respective objectives. RESEARCH METHOD The researcher firstly conducted a literature review to understand self-care and related constructs. Thereafter the researcher employed two structured questionnaires, the ASA-A and ESCA, were employed to collect data. The questionnaires were developed to measure self-care (self-care is determined by measuring the self-care agency). These questionnaires were based on Dorothea OrenYs self-care deficit theory of nursing, the same theory that this research study is based on. Minor adaptations were made to both the questionnaires prior to administration to the predominantly Setswana-speaking older population. The study formed part of the larger Multinational Prospective Urban and Rural Epidemiological study (PURE-SA study - ethical approval number 04M10). All the older persons identified in the peri-urban population of the PURE-SA study living in the Potchefstroom district and who were willing to participate were included in the sample. Trained fieldworkers assisted the researcher in data collection. Of the 198 older persons, 192 participated, accumulating to a 98% response rate. Lastly the researcher correlated the ASA-A and ESCA to determine their relationship as an added benefit to this research study. RESULTS The findings indicate that although the studied older population was of a lower socio-economic status with a lower literacy level, their overall self-care was relatively good. Seven self-care deficits were identified namely time management skills affecting self-care, energy deficit affecting self-care, sleep deprivation, lack of knowledge and ability to acquire knowledge with regard to health and self-care, lack of a rest, exercise and self-care programme, self-care deficit caused by physical deterioration and, lastly, the lack of performance of activities to prevent/decrease self-care deficits. These identified self-care deficits supported the development of guidelines to facilitate self-care amongst older persons, together with Menon's psychological health empowerment model, as well as an in-depth literature review on self-care and related constructs to understand self-care from a theoretical perspective. Furthermore, the study compared the ASA-A and ESCA questionnaires to determine the relationship between these questionnaires. The two questionnaires had a very good correlation with each other, conclusion that either of these two questionnaires could be used to measure self-care of a population. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2010.

Problema de saúde pública de prevalência global, a diabetes está em franca expansão em todo planeta, vinculada ao contexto socioeconômico, às condições de urbanização e ao envelhecimento populacional. Estimativas da Organização Mundial da Saúde indicam que existem, atualmente, 387 milhões de pessoas vivendo com diabetes no mundo. Quarto colocado no ranking da International Diabetes Federation, o Brasil tem 11,6 milhões de adoecidos, 10% dos quais insulinodependentes. É nesse cenário epidêmico que se dá a construção de redes e sentidos de cuidado e autocuidado da diabetes baseados em práticas e conceitos elaborados por actantes os mais diversos, das políticas públicas brasileiras de saúde coletiva a profissionais de saúde e adoecidos crônicos. Assim, o objetivo deste trabalho é analisar como as redes e seus actantes humanos e não humanos (políticas públicas, rede de atenção à saúde, profissionais de saúde, pacientes, amigos e familiares, medicamentos, insumos e tecnologias) performam e são performados na produção de cuidado e autocuidado no cotidiano dos serviços especializados. Para tanto foi realizado um estudo etnográfico, por meio de observação participante e entrevistas semiestruturadas de profissionais de saúde e usuário de unidade de atenção secundária do município de São Bernardo do Campo, no ABCD paulista. O objetivo foi, assim, contribuir para o entendimento das relações entre atores os mais diversos a partir de produção de cuidado e autocuidado e, consequentemente, refletir sobre a saúde coletiva e os projetos terapêuticos mais próximos dos contextos culturais e das singularidades de adoecidos crônicos e profissionais de saúde. / Public health problem of global prevalence, diabetes is booming across the planet, linked to the socioeconomic context, conditions of urbanization and population aging. Estimates from the World Health Organization indicate that there are currently 387 million people living with diabetes worldwide. Fourth place in the ranking of the International Diabetes Federation, Brazil has 11.6 million sickened, 10% of which insulin dependent. It is in this epidemic scenario that gives the building of care and self-care networks and their senses of diabetes based on established practices and concepts of the most diverse actants, from Brazilian public health policy to health professionals and chronic ill. The objective of this study is to analyze the networks and their human and non-human actants (public policy, health care network, health professionals, patients, friends and family, medicines, supplies and technologies) enact and are enacted in the production of care and self-care in the routine of medical specialized services. The study is an ethnography using participant observation and semi-structured interviews of health professionals and users of public specialized medical care unit in São Bernardo do Campo, São Paulo ABCD. The aim was thus to contribute to the understanding of the relationships among the various actors from care and self-care production and consequently reflecting on public health and the therapeutic projects of chronic ill and health professionals on their cultural contexts and singularities.

Problema de saúde pública de prevalência global, a diabetes está em franca expansão em todo planeta, vinculada ao contexto socioeconômico, às condições de urbanização e ao envelhecimento populacional. Estimativas da Organização Mundial da Saúde indicam que existem, atualmente, 387 milhões de pessoas vivendo com diabetes no mundo. Quarto colocado no ranking da International Diabetes Federation, o Brasil tem 11,6 milhões de adoecidos, 10% dos quais insulinodependentes. É nesse cenário epidêmico que se dá a construção de redes e sentidos de cuidado e autocuidado da diabetes baseados em práticas e conceitos elaborados por actantes os mais diversos, das políticas públicas brasileiras de saúde coletiva a profissionais de saúde e adoecidos crônicos. Assim, o objetivo deste trabalho é analisar como as redes e seus actantes humanos e não humanos (políticas públicas, rede de atenção à saúde, profissionais de saúde, pacientes, amigos e familiares, medicamentos, insumos e tecnologias) performam e são performados na produção de cuidado e autocuidado no cotidiano dos serviços especializados. Para tanto foi realizado um estudo etnográfico, por meio de observação participante e entrevistas semiestruturadas de profissionais de saúde e usuário de unidade de atenção secundária do município de São Bernardo do Campo, no ABCD paulista. O objetivo foi, assim, contribuir para o entendimento das relações entre atores os mais diversos a partir de produção de cuidado e autocuidado e, consequentemente, refletir sobre a saúde coletiva e os projetos terapêuticos mais próximos dos contextos culturais e das singularidades de adoecidos crônicos e profissionais de saúde. / Public health problem of global prevalence, diabetes is booming across the planet, linked to the socioeconomic context, conditions of urbanization and population aging. Estimates from the World Health Organization indicate that there are currently 387 million people living with diabetes worldwide. Fourth place in the ranking of the International Diabetes Federation, Brazil has 11.6 million sickened, 10% of which insulin dependent. It is in this epidemic scenario that gives the building of care and self-care networks and their senses of diabetes based on established practices and concepts of the most diverse actants, from Brazilian public health policy to health professionals and chronic ill. The objective of this study is to analyze the networks and their human and non-human actants (public policy, health care network, health professionals, patients, friends and family, medicines, supplies and technologies) enact and are enacted in the production of care and self-care in the routine of medical specialized services. The study is an ethnography using participant observation and semi-structured interviews of health professionals and users of public specialized medical care unit in São Bernardo do Campo, São Paulo ABCD. The aim was thus to contribute to the understanding of the relationships among the various actors from care and self-care production and consequently reflecting on public health and the therapeutic projects of chronic ill and health professionals on their cultural contexts and singularities.